Cat-Scratch Disease Presenting as Abdominal Visceral Granulomas

• Published in: The Journal of infectious diseases 1990-01, Vol.161 (1), p.71-78
• Main Authors: Delahoussaye, Peggy M., Osborne, Barbara M.
• Format: Article
• Language: English
• Subjects: Adult; AIDS; AIDS/HIV; Bacillus; Bacterial adenopathies; Bacterial diseases; Biological and medical sciences; Biopsies; Biopsy; Cat scratch fever; Cat-Scratch Disease - complications; Cat-Scratch Disease - pathology; Child; Children; Granuloma; Granuloma - complications; Granuloma - etiology; Hepatitis; HIV Infections - complications; Human bacterial diseases; Humans; Infectious diseases; Laparotomy; Liver; Liver Diseases - diagnosis; Lymph nodes; Major Articles; Male; Medical sciences; Middle Aged; Spleen; Splenic Diseases - diagnosis; Staining and Labeling; Viscera - microbiology; Viscera - pathology
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/161.1.71

Three cases of atypical, clinically unsuspected cat-scratch disease (CSD), diagnosed by demonstration of the CSD bacillus in an abdominal visceral organ, are presented. In two cases CSD bacilli were demonstrated for the first time in splenic granulomas in a child and in an adult with acquired immunodeficiency syndrome (AIDS)-related complex. In both cases, there was granulomatous hepatitis as well as splenitis. In the third case, the CSD bacillus was present in hepatic granulomas in an adult with granulomatous hepatitis. In all cases, granulomatous inflammation with suppuration in the viscera was identical to that previously described for lymph nodes in CSD. All patients eventually recovered completely. Clinical awareness of the broad spectrum ofCSD should avoid the cost and morbidity of prolonged hospitalization, medications, and invasive surgery for a disease that is self-limited and not clearly responsive to antibiotics and that can usually be diagnosed by noninvasive means.